1. Field of the Invention
This invention relates to data management and more particularly relates to an apparatus, a system and a method for member matching.
2. Description of the Related Art
Evaluation of health care claims data at the member level is hindered by lack of access to complete information for members who move from one plan to another. This is especially problematic when the analysis is done for an individual health plan and only data from that plan is available for use. It is complicated by the fact that patients are mobile, visit multiple providers and enroll in multiple plans. The challenge is to uniquely identify members across the health plans and create non-duplicative eligibility records. This requires matching members or data records across health plans.
Typical record matching solutions require the use of a social security number or other unique identifiers that are common among the several datasets. Unfortunately, most healthcare plans and other data providers, such as financial institutions, are unwilling or unable to supply social security numbers or other unique identifiers because of privacy concerns.
The referenced shortcomings are not intended to be exhaustive, but rather are among many that tend to impair the effectiveness of previously known techniques for member matching; however, those mentioned here are sufficient to demonstrate that the methodologies appearing in the art have not been satisfactory and that a significant need exists for the techniques described and claimed in this disclosure.